中国神经再生研究(英文版) ›› 2021, Vol. 16 ›› Issue (10): 1985-1991.doi: 10.4103/1673-5374.308072

• 综述:退行性病与再生 • 上一篇    下一篇

神经丝在肌萎缩侧索硬化症中的应用现状及展望

  

  • 出版日期:2021-10-15 发布日期:2021-03-19

Current application of neurofilaments in amyotrophic lateral sclerosis and future perspectives

Yuri Matteo Falzone1, 2, Tommaso Russo1, 2, Teuta Domi1, Laura Pozzi1, Angelo Quattrini1, Massimo Filippi2, 3, 4, 5, Nilo Riva1, 2, *#br#   

  1. 1Neuropathology Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Milan, Italy; 2Neurology and Neurorehabilitation Unit, IRCCS SanRaffaele Scientific Institute, Milan, Italy; 3Neurophysiology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy; 4Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy; 5Vita-Salute San Rafaele University, Milan, Italy
  • Online:2021-10-15 Published:2021-03-19
  • Contact: Nilo Riva, MD, PhD, riva.nilo@hsr.it.

摘要:

Neural Regen Res神经丝在肌萎缩侧索硬化症中作为新的潜在生物标志物

运动神经元疾病包括以运动神经元退化为特征的持续进行性神经系统疾病。肌萎缩侧索硬化症是运动神经元疾病中最常见和最具侵袭性的一种,至今尚无有效的治疗方法。不幸的是,临床实践中缺乏诊断和预后的生物标志物。神经丝是轴突的基本结构成分,脑脊液和血清中均可检测到神经丝轻链和磷酸化神经丝重链。肌萎缩侧索硬化症患者神经丝轻链和磷酸化神经丝重链水平升高,反映了运动神经元和轴突的广泛损伤。因此,神经细丝现在越来越被认为是肌萎缩侧索硬化最有希望的候选生物标志物。神经丝的潜在用途涉及多个方面,包括诊断、预后、临床试验中的患者分层和治疗效果的评估。

来自美国波士顿大学医学院的Nilo Riva团队认为迫切需要在肌萎缩侧索硬化症中应用可靠的生物标志物。神经丝有望在诊断过程中,在描述预后和改善临床试验设计方面有帮助。此外,神经丝水平在疾病发生之前和期间的动态变化为更好地理解肌萎缩侧索硬化症及其临床变体的生理病理学提供了一个独特的机会。神经丝的临床应用似乎即将到来,但仍有一些问题需要解决,包括分析技术的标准化、两个神经丝亚基中哪一个应该被评估以及精确的以实践为导向的界限的划定等。从未来的角度来看,神经丝可能被纳入临床诊断方案,甚至作为辅助诊断标准。  

文章在《中国神经再生研究(英文版)》杂志202110 10 期发表。

https://orcid.org/0000-0002-0513-9517 (Nilo Riva)

Abstract: Motor neuron disease includes a heterogeneous group of relentless progressive neurological disorders defined and characterized by the degeneration of motor neurons. Amyotrophic lateral sclerosis is the most common and aggressive form of motor neuron disease with no effective treatment so far. Unfortunately, diagnostic and prognostic biomarkers are lacking in clinical practice. Neurofilaments are fundamental structural components of the axons and neurofilament light chain and phosphorylated neurofilament heavy chain can be measured in both cerebrospinal fluid and serum. Neurofilament light chain and phosphorylated neurofilament heavy chain levels are elevated in amyotrophic lateral sclerosis, reflecting the extensive damage of motor neurons and axons. Hence, neurofilaments are now increasingly recognized as the most promising candidate biomarker in amyotrophic lateral sclerosis. The potential usefulness of neurofilaments regards various aspects, including diagnosis, prognosis, patient stratification in clinical trials and evaluation of treatment response. In this review paper, we review the body of literature about neurofilaments measurement in amyotrophic lateral sclerosis. We also discuss the open issues concerning the use of  neurofilaments clinical practice, as no overall guideline exists to date; finally, we address the most recent evidence and future perspectives.

Key words: amyotrophic lateral sclerosis, biomarkers, motor neuron disease, neurofilament light chain, phosphorylated neurofilament heavy chain